Cold storage of citrated whole blood induces drastic time-dependent losses in factor VIII and von Willebrand factor: potential for misdiagnosis of haemophilia and von Willebrand disease.

Author(s): Böhm M, Täschner S, Kretzschmar E, Gerlach R, Favaloro EJ, Scharrer I

Publication: Blood Coagul Fibrinolysis, 2006, Vol. 17, Page 39-45

PubMed ID: 16607078 PubMed Review Paper? No

Purpose of Paper

Conclusion of Paper

Studies

1. Study Purpose

   The purpose of this study was to determine the effects of storage of whole blood or separated plasma on crushed ice or at room temperature on VWF:RCo, VWF:Ag, FVIII:C, and VWF multimers. All specimens were frozen at -20 degrees C prior to analysis. Blood was anticoagulated with sodium citrate.

   Summary of Findings:

   In healthy individuals and patients with suspected type 1 VWD, VWF:RCo, VWF:Ag, and FVIII:C decreased by 65, 44, and 46%, respectively after whole blood was stored on ice for 6 hours. VWF:RCo and VWF:Ag were not significantly affected when either whole blood or plasma was stored at room temperature or when plasma was stored on ice. However, FVIII:C was significantly decreased for all storage conditions when compared to control specimens stored for 3 hours at room temperature as whole blood. The decrease in FVIII:C was greatest for specimens stored as whole blood on ice. Specimens from patients with type 2N VWD exhibited decreases in VWF:RCo, VWF:Ag, and FVIII:C similar to healthy individuals and those with suspected type 1 VWD after 6 hour cold storage of whole blood. However, much smaller decreases were seen in VWF:Ag, and FVIII:C (0-28 and 0-16%, respectively) under the same storage conditions for patients with type 2A and 2B VWD (undetectable VWF:RCo). Storage of platelet-rich plasma from healthy individuals for 3 hours on crushed ice caused significant decreases in VWF:RCo, VWF:Ag, and FVIII:C, similar to storage of whole blood on ice. Preferential loss of intermediate and large VWF multimers was seen after cold storage of whole blood from a healthy individual and a patient with suspected type 1 VWD. A patient with type 2 VWD, lacking large and intermediate multimers, exhibited loss of the largest multimers that were present at room temperature after cold storage of whole blood.

   Biospecimens

   • Bodily Fluid - Blood
   • Bodily Fluid - Plasma

   Preservative Types

   • Frozen

   Diagnoses:

   • Normal
   • Other diagnoses

   Platform:

   Analyte	Technology Platform
   Protein	Hematology/ auto analyzer
   Morphology	Hematology/ auto analyzer
   Protein	Western blot
   Protein	Immunoassay

   Pre-analytical Factors:

   Classification	Pre-analytical Factor	Value(s)
   Preaquisition	Diagnosis/ patient condition	Suspected type 1 von Willebrand disease Confirmed type 2 von Willebrand disease
   Storage	Storage temperature	Room temperature Crushed ice -20 degrees C
   Storage	Storage duration	3 h 6 h
   Biospecimen Aliquots and Components	Blood and blood products	Platelet-poor plasma Platelet-rich plasma Whole blood
   Biospecimen Aliquots and Components	Centrifugation	Centrifugation delays investigated

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